Cedar Court Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last inspection we rated this key question inadequate. At this inspection the rating has changed to requires improvement. This meant people’s needs were not always met.

At the last inspection, we found the service was in breach of regulation in regard to involving people and relatives in care, providing information to people in an accessible way. At this inspection, while improvements had been made, we found the service was still in breach of providing information to people in an accessible way.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs. A person’s care plan recorded them as not being native to the United Kingdom and having limited ability to speak and understand English; and being able to be understood and understand others. The person’s care plan recorded them as having a book to aid their communication with staff.

During the inspection, the person was observed to be distressed and frustrated, and we observed staff not communicating with them. The persons communication book was in their bedroom and was not being utilised by staff when they were in the lounge/dining area. We spoke to staff who told us they were unable to effectively communicate with the person and vice versa and this frequently led to the person’s distress and frustration, which could impact on others living at the service and staff. We fed this back to the management team who has since advised us they had attended a multi-disciplinary meeting to review alternative support that could be provided to this person.

While care plans documented peoples need, some had no personalised information on how to fully support people. For example, people living with diabetes had no personalised information about their specific care need in relation to this for their individual care need. For example, how to manage or identify a person going into hypo or having low blood sugar was not always documented.

However, people and their relatives told us they were involved in the planning of their care. Relatives told us they were involved in any changes required around people’s care needs before they were implemented. Adjustments to people’s care was discussed with relatives and health and care professionals as required.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. Some people told us they did not get out in the community although they wanted to do so. This meant some people did not receive full care and support in relation to socialising or accessing the community as they required.

Some care plans had some detail of people’s cultural backgrounds. We received no complaints about the choices of meals that were provided to people. However, there was no options available for people to have meals in line with their cultural background provided by the service. We discussed this with the management team who told us they would look into how they could bring diversity into the menu’s available if it suited people using the service.

The provider did not always supply information in formats that were tailored to individual needs.

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment or sensory loss and in some circumstances to their careers. People’s communication needs were recorded in their care plans; AIS was not fully implemented within the service. For example, the service had a board which displayed all of the activities and services available for people to participate in. However, the information and pictures were presented in a small format, located on a wall in the corridor which could be easily missed by people. Also, the format would have been difficult for some people to read. This left people at risk of missing out on important information, and activities which could benefit their wellbeing.

The provider did not always make it easy for people to share feedback, or raise complaints about their care, treatment and support. We received mixed feedback in regard to this. People told us calls to the office often went unanswered and there was no facility for people to leave a message. One relative told us, “It took me 9 weeks to get a response from them.” Another relative told us, “I used to be able to contact them easily, now you can’t leave a message or get the phone answered.”

However, we did receive feedback from people who thought they were listened to. We received comments like, “Yes, I have done 2 or 3 surveys and attended meetings to discuss the [service]. I get copied into emails.” Another relative said, “They keep me up to date with what is happening with [relative]” The evidence we gathered showed a lack of consistency with people being able to have their voices heard, including the ability to raise concerns about their care. This left some people at the risk of avoidable harm if their relatives were not able to make contact the management team on the phone timely to raise any concerns as required.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. One person told us they wanted their relative to be referred to a podiatrist, but they thought this request had been put, “...on the back burner.” A healthcare professional told us of an extensive delay in receiving a referral from the service for a person who needed an assessment at the GP. While the referral was eventually received, the delay put the person at risk of avoidable harm due to the delay. The evidence showed that while there were checks and reviews of managing the service in place, these were not always robust enough to prevent delays to people’s care and treatment.

However, care records demonstrated people were able to access services, including a range of external healthcare services and professionals as needed. For example, they were able to access speech and language therapy services, GP, dietician, district nurse service and chiropody. There was no further evidence or information to suggest people experienced delays in healthcare provision. Some healthcare professionals told us they worked well with the service to support people in accessing care and support timely.

Staff and leaders did not always actively listen to information about people most likely to experience inequality in experiences or outcomes. The evidence we saw showed people did not have equity in experiences and outcomes, and sufficient measures were not taken to ensure people most likely to experience inequality in experiences and outcomes were protected from this.

While the service had an activities lead employed, some relatives told us they thought there was a “Significant lack of activities for [people.]” However, other people and their relatives praised activities that were provided but told us “Trips had been curtailed, and people were not going out into the community.” The service had a sensory room, which was open and available for people to use, however some people told us they were not aware of this and believed the sensory room was out of use. This meant some people using the service were not benefiting from the activities available, limiting their social activities, and affecting inclusiveness and wellbeing. We raised this with the management team, who told us they would take steps to ensure all people were aware of activities and events available in the service.

People living with dementia did not experience equality within the service. The décor of the service had no high contrasting colours or colour coded areas to help prevent people becoming lost or confused. There was no keypad on the lift in the service, this posed a risk to people living with dementia who could gain access unsafely.

Notice boards with information about services and activities were located near the entrance of the service. The information was presented in small print and would have made accessibility difficult to people living with dementia, or people who required additional support with vision. We raised these points with the management team. They advised us the points that we had raised would be taken into consideration to implement with the refurbishment of the building that was taking place at the time of the inspection.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Care plans were designed so people could document their advanced care plans if they wished to. The service had an end-of-life policy in place. We spoke to relatives of people receiving end of life support at the service. They told us they were kept well informed in relation to any changes in the needs or condition of their relative, and they were happy with the support they received.